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What does my PFT test report indicate?

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Posted on Sat, 21 May 2016
Question: I followed your last suggestion and went and had a pft taken along with a chest X-ray. The results of the test were normal excluding the fev25/75 it was around its usual 60-70 mark. We did a albuterol test and that rating and the peg 50 jumped up to normal. Once again the dr assessed mild asthma. So I guess I'll accept that.
With the fact that I have continuing anxiety and stress and now asthma, I must ask the question, what is the cause of my lung disorder If I give an exertion that increases my breathing and I go to mouth breathing, I can only take a short breath.

Is this a combination of stress and asthma? What other possibility could limit inflow of air through the mouth.

I will attempt to send a copy of the results for you to read and comment on
doctor
Answered by Dr. Kaushal Bhavsar (9 hours later)
Brief Answer:
You are having small airway obstruction.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
I have gone through the reports you have attached.
Your PFT report is normal except, FEV25-75.
This showed lower value initially and improved value after bronchodilator.
FEV25-75 is the marker of small airways. So you are mostly having small airway obstruction. Your other PFT values are normal. So no need to worry for asthma or COPD.
Small airway obstruction is the likely cause for this.
And stress can cause this.
On longer run, this small airway obstruction can lead to chronic bronchitis and chronic asthma.
So I think stress is the likely cause for your small airway obstruction.
Causes for reduced inflow of air through mouth are
1. Enlarged adenoids
2. Enlarged tonsils.
3. Spasm of phyryngreal muscles.
4. Laryngeal spasm.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Kaushal Bhavsar (35 hours later)
I appreciate your answer and will see what you have mentioned might be cause.

What precisely do you mean with stress affecting the fev25/75 midflow can it cause airways to tighten up or what
doctor
Answered by Dr. Kaushal Bhavsar (13 hours later)
Brief Answer:
Stress causes inflammatory reaction in airways.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Sorry for late reply as I was busy because of weekend.
Stress is proven risk factor for small airway disease.
stress operates by altering the magnitude of the airway inflammatory response that irritants, allergens, and infections bring about in persons. Stress on its own is NOT capable of modifying immune functions in a way that leads to small airway symptoms. Rather, stress is viewed as a process that accentuates the airway inflammatory response to environmental triggers and, in doing so, increases the frequency, duration, and severity of patients' symptoms.
So please let me know how is your current stress level?
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kaushal Bhavsar (4 hours later)
Current stress level is very high due to attempts to overcome this sensation of hard time breathing as I once did but yet having pft that shows normal.
doctor
Answered by Dr. Kaushal Bhavsar (13 minutes later)
Brief Answer:
Is it not possible for you to forget these things and enjoy your life.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
Please let me know, is it not possible for you to forget these things and enjoy your life?
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (3 hours later)
I am trying but I wake each morning to fund that even though I went to sleep relaxed with positive thought I wake in the night and while I'm awake I look to see if I have same issues If my mind is presenting false perceptions of my breathing than I must learn to overcome.

The question that I will need a good answer to is this. I have mentioned a limited intake of air like when I yawn or take a quick breath after exerting myself. My lungs just stop from that which I once took in. I can't tell if this is actual or mentally created. My PFTs show great numbers except for the midflow.
If mentally generated, what is triggering a shutoff or a bstruction to my inhale. Is sress mimicking the asthma like airway tightening or actually triggering athe body to react

Your thoughts
doctor
Answered by Dr. Kaushal Bhavsar (37 minutes later)
Brief Answer:
Uncontrolled stress is causing inflammatory changes in airways.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
I think there is vicious cycle running in your mind which is not letting you forget these things.
Your uncontrolled stress and anxiety are causing inflammatory changes in airways.
This reflects in PFT as small airway obstruction.
You are better when your stress levels are low. You yourself admitted this.
Please let me know
1. When did you consult psychiatrist? (recent one)
2. When you are asymptomatic, do you have any sort of stress and anxiety?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (15 minutes later)
I will combine the conversations of three physicians that I have spoken with recently They are Dr Cantrall pulminologist here in my home area, Dr XXXXXXX Sheppe, psychiatrist at HCM, and you.

Dr Cantrell on an in office check up reviewed my PFTs from previous Drs, looked at family history, especially my mother who died of copd at 91 after smoking for 70+ years, did a in office physical and concluded that I should live to be an old old man. That he could not find any indication of copd. He said if anything I may have very mild asthma

Three weeks later I take a pft after complaining of breathing issues. The results you have seen. The Drs response was. No copd, just very mild asthma. You will live long life. See you in a year Relax and get through your stress anxiety and you will feel better.

Dr Sheppe has seen the reports and initially agreed with the asthma. But then he changed to agree with your conclusion. He has been talking with me for a long period now. He has seen my previous PFTs and he also has a more in depth understanding of my stress/anxiety/and panic related issues. He has mentioned that stress can mimick some asthma symptoms and the use of albuterol does not always help. He is adamant that my problems are all anxiety driven

You too say no copd and no asthma. You also agree that I have anxiety that controls my breathing issues. I have some symptoms that affect my breathing that if not copd nor asthma are they anxiety or just those that come with growing old. The symptom is trying to take a deep breath after exerting myself. For example I was throwing a football in the yard to my stepson. After a few minutes of running back and forth i was breathing harder as I tried to take a deep breath as I have before, I find that I could only get a short breath. This event occurred during a time that I was dealing with higher than usual extended period stress. Plus I was out of shape from lack of good exercise.

If I could get a good understanding of that obstruction issue and what is behind it, I nay get it in control. All say no copd. Asthma is not 100% agreed on but all are in agreement on anxiety and stress. If that is causing my airways to limit inflow or I have some air that I'm not getting out as I exert it would help

Reply
doctor
Answered by Dr. Kaushal Bhavsar (37 minutes later)
Brief Answer:
Have you tried Yoga and meditation?

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
We all doctors are trying to convince you that you are not suffering from major organic disease. So you will die soon.
Your all symptoms are associated with stress and anxiety.
So don't think negatively.
For your deep breathing issue and trapped air issue, in my opinion, you should start Yoga and meditation.
These will also help in reducing stress and anxiety.
Please let me know, have you tried Yoga and meditation?
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (1 hour later)
Thanks for responding quickly today. First I will assume you meant to say "so you will NOT die soon instead of you will die soon.

I want to try yoga, I have planned that many times over the years but stop after it asks for moves requiring great balance and I fail and stumble. I guess I need to try harder.

Meditation is great. If you can keep from falling asleep. I have an issue that sends me right to sleep

I will look for something that keeps my mind occupied but relaxed.

I have to say that this thread has been very helpful. I put much more info out this time and you seemed to piece it together well and assembled answers that make more sense. I'm sure I will keep stumbling along but as long as I improve bit by bit than its ok I guess
doctor
Answered by Dr. Kaushal Bhavsar (15 minutes later)
Brief Answer:
I am extremely sorry for typing error.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I am so sorry for typing error. You will definitely live longer and not going to die soon.
Sorry again, I didn't mean that.
It's great that my advice are helpful to you.
Yes, yoga is a bit difficult in initial phase but once you used to it, it will be easy.
Meditation is excellent for mind peace.
Don't worry, you will be alright. Forget everything, focus on peace only.
Thanks for your kind words.
I am truly overwhelmed by your reply. It's always great to hear feedback from you.
Hope I have solved your query. If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health as always. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar (1 minute later)
I will respond another time at the other address you gave. Thx much
doctor
Answered by Dr. Kaushal Bhavsar (1 hour later)
Brief Answer:
Sure. I will wait for your query.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
It's always pleasure to have you on other side.
Do let me know your progress.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Kaushal Bhavsar

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What does my PFT test report indicate?

Brief Answer: You are having small airway obstruction. Detailed Answer: Thanks for your question on Health Care Magic. I can understand your concern. I have gone through the reports you have attached. Your PFT report is normal except, FEV25-75. This showed lower value initially and improved value after bronchodilator. FEV25-75 is the marker of small airways. So you are mostly having small airway obstruction. Your other PFT values are normal. So no need to worry for asthma or COPD. Small airway obstruction is the likely cause for this. And stress can cause this. On longer run, this small airway obstruction can lead to chronic bronchitis and chronic asthma. So I think stress is the likely cause for your small airway obstruction. Causes for reduced inflow of air through mouth are 1. Enlarged adenoids 2. Enlarged tonsils. 3. Spasm of phyryngreal muscles. 4. Laryngeal spasm. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.